Despite knowledge that EGDT improves outcomes in septic patients, staff education on EGDT and compliance with the CPOE order set has been variable. Based on results of a resident survey to identify barriers to decrease severe sepsis/septic shock mortality in the medical intensive care unit (MICU), multifaceted interventions such as educational interventions to improve awareness to the importanc...

BACKGROUND Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. OBJECTIVES To undertake a descriptive overvi...

Ventilator associated pneumonia (VAP) remains a worldwide harm associated with hospital acquired infection. Our VAP rate at King Abdulaziz Medical City was 4.0 per 1 000 patient days at baseline. All regulatory bodies continue to emphasize the importance of reducing these infections and include a guideline of practice recommendations to address them, notably the VAP bundle by the Institute for ...

BACKGROUND The use of benzodiazepines has been advised against in older people, but prevalence rates remain high. AIMS To review the evidence for interventions aimed at reducing benzodiazepine use in older people. METHOD We conducted a systematic review, assessment of risk of bias and meta-analyses of randomised controlled trials of benzodiazepine withdrawal and prescribing interventions. ...

PURPOSE The physical demands and hazards associated with emergency service work place particular stress on responders' cardiovascular systems. Indeed, cardiovascular disease (CVD) is a significant problem for emergency service personnel. Although it may be difficult to alter the cardiovascular health hazards associated with the work environment, it is possible for personnel to control their mod...

BACKGROUND Reducing avoidable readmission and posthospitalization emergency department (ED) utilization has become a focus of quality-of-care measures and initiatives. For pediatric patients, no systematic efforts have assessed the evidence for interventions to reduce these events. PURPOSE We sought to synthesize existing evidence on pediatric discharge practices and interventions to reduce h...

BACKGROUND Transfusion services have used various techniques to reduce blood product utilization. Given the potential adverse effects of transfusions and the resources consumed in implementing strategies to reduce transfusions, there is a need to understand their effectiveness. Therefore, we performed a systematic review of the literature to examine the effectiveness of behavioral interventions...

Few studies have monitored change in professional practice over time to determine the sustainability of change. Research from other behavioural change literature shows that initial change is difficult to maintain, with reported relapse rates as high as 80%. Interventions most likely to succeed are based on a clear understanding of target behaviours and the environmental context. Facilitators an...